425145

Effectiveness of Distraction Principle by External Circular Frame in Correction of Postburn Wrist Contracture

Article

Last updated: 04 May 2025

Subjects

-

Tags

Hand and Upper Limb Surgery'

Abstract

Background: Although it is preferable to prevent post-burn
contractures of the upper extremities rather than to cure them,
Many patients, nonetheless, experience this handicap, particularly
following serious burns or inadequate primary care.
Plastic surgeons find Post-burn Fixed Flexion Deformity
(FFD) of the wrist to be difficult to treat because of its intricacy
and severe impact on patient impairment. Even though
Post-burn flexion contracture deformity has been treated with
surgical release and reconstruction extensively, the surgery is
not without major difficulties, and the degree of rectification is
not always sufficient.
Objective: This case series study was conducted to evaluate
the effectiveness and safety of Ilizarov's principles of distraction
neo histiogenesis and differential distraction as a minimally
invasive technique for correction of post burn soft tissue
contracture deformity of the wrist joint without any concurrent
bony procedures to prevent the risks associated with release and
reconstructive surgery and to achieve long-term improvement
With no complication or recurrence.
Results: A total of 15 consecutive patients with a mean age
of 32 years (11 to 40) had distraction for a Mean period of 25
days (21 to 30). The fixator was removed after a mean of 38
days (35 to 42) when the wrist was in neutral position, followed
by physiotherapy. Final Assessment after a 12-month period
showed improvement in functional position that allowed more
active movement of the hand, and appearance had markedly improved.
Without any serious consequences, every patient had
their deformity completely corrected.
Conclusion: Although surgical release and reconstruction
have been used extensively to treat severe post burn wrist flexion
contractures, the degree of correction is sometimes unsatisfactory,
and the procedure is not exempt from significant complications.
Based on the principle of slow, gradual differential
distraction, we mounted a circular frame distractor to deal with  joint contractures. This is a percutaneous surgery, with very
mild aggression to the patient and very low iatrogenic risks.
The technique is easy, the degree of correction may be almost
complete, and the hospital stay is limited.

DOI

10.21608/ejprs.2025.425145

Keywords

Burn, wrist, Ilizarov, Contracture, fixator

Authors

First Name

SHERIEN

Last Name

SALAMA

MiddleName

Metwally

Affiliation

The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University

Email

-

City

Cairo

Orcid

-

First Name

AMR

Last Name

FAYED

MiddleName

MAHMOUD

Affiliation

The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University

Email

-

City

Cairo

Orcid

-

First Name

AHMED

Last Name

Gadallah

MiddleName

-

Affiliation

The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University

Email

-

City

Cairo

Orcid

-

Volume

49

Article Issue

2

Related Issue

55420

Issue Date

2025-04-01

Receive Date

2025-04-30

Publish Date

2025-04-01

Page Start

123

Page End

133

Print ISSN

1110-0044

Online ISSN

2974-4709

Link

https://ejprs.journals.ekb.eg/article_425145.html

Detail API

http://journals.ekb.eg?_action=service&article_code=425145

Order

7

Type

Original Article

Type Code

1,110

Publication Type

Journal

Publication Title

The Egyptian Journal of Plastic and Reconstructive Surgery

Publication Link

https://ejprs.journals.ekb.eg/

MainTitle

Effectiveness of Distraction Principle by External Circular Frame in Correction of Postburn Wrist Contracture

Details

Type

Article

Created At

04 May 2025